Prevalence and Determinants of Substance Use Among Students at Kampala International University Western Campus, Ishaka Municipality Bushenyi District Uganda

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EURASIAN EXPERIMENT JOURNAL OF MEDICINE AND MEDICAL SCIENCES (EEJMMS)
ISSN: 2992-4103
©EEJMMS Publications Volume 5 Issue 1 2024
Page | 13 Prevalence and Determinants of Substance Use among

Students at Kampala International University Western
Campus, Ishaka Municipality Bushenyi District Uganda
Kuteesa Arnold James
Faculty of Clinical Medicine and Dentistry of Kampala International University, Western Campus Uganda
ABSTRACT
During the University period, students experience independence and freedom from direct adult and family
supervision, self-decision and intense academic pressures as well as sharing living quarters with people they barely
know. They also form new social groups and may be exposed to values different from their parental values. These
new values may motivate the youth to indulge in unhealthy behaviors such as smoking, alcohol and illicit drug use.
Undergraduate students make the transition from a restricted life monitored by parents to a more self-directed life
influenced by the university environment and as such, the risk of substance use was increased in university
environments. The study sought to determine the prevalence and establish the determinants of substance use
among students at Kampala International University-Western Campus. A cross-sectional observational and
analytic study design was utilized. A total of 176 randomly selected participants were recruited in the study.
Bivariate and multivariate logistic regression was performed to identify factors associated with substance use.
Odds ratios with a 95% confidence interval were computed to determine the level of significance. The majority of
the study participants 125 (71.02%) were female participants whereas the minority of participants 51 (28.98%)
were males. The majority of study participants 54 (30.68%) of the study participants belonged to the catholic
religion. The prevalence of substance use among the study participants was 56.82% (100). The most used
substance abuse was alcohol, followed by marijuana and shisha. The substances of abuse least used were cocaine,
gasoline, and opium. Poor role modelling by teachers, Stressful finance clearing, too much freedom at campus, and
weight management were independently significantly associated with substance use among study participants.
This study has shown that the level of substance abuse was high among the students at KIU-WC. Most of the
determinants of substance use were due to school-related factors such as stressful financial clearing, poor role
modelling by lecturers, and too much freedom on campus. Lecturers should portray a good example to the
students since poor role modelling was found to be associated with substance use. Parents should endeavour to
provide all the financial needs to their sons and daughters.
Keywords: University environment, Substance abuse, Parents, Students, Alcohol.
INTRODUCTION
Substance abuse and its associated problems are a global concern. A recent WHO estimate shows a burden of
worldwide psychoactive substance use of around 2 billion alcohol users, 1.3 billion smokers and 185 million drug
users [1]. The World Health Organization has defined substance use as, “persistent or sporadic use inconsistent
with or unrelated to acceptable medical practice[2]. The use of these drugs among University students is a global
phenomenon eating deep into the fabric of our society[3]. In the past few years, substance and drug abuse has
been on the rise in Uganda, and it has engulfed the whole country [4] Drug and substance abuse has been pointed
out as one of the reasons for several problems such as a rising crime rate, unrest in schools, dysfunctional families,
and poverty [4]. It has also been observed that as a result of substance and drug abuse, the following effects have
occurred: domestic violence, risky sexual behaviors and practices including exposure to HIV/AIDS [5]. There
seems to be an increased prevalence of substance and drug abuse amongst university students, despite the efforts
of the authorities to put their house in order [6]. This study as such sought to find out the prevalence and the
©Kuteesa, 2024
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determinants of substance and drug abuse among students at Kampala International University-Western Campus.
The history of the human race has also been associated with substance abuse. For a long time, man has been using
herbs, bark leaves and roots to relieve pain and help control diseases and most young people begin their use of
drugs with alcohol and cigarettes and later progress to more dangerous substances such as cannabis and
cocaine[7]. As we find ourselves at the beginning of a new decade, we are faced with challenges to our survival.
Some of the greatest threats to our survival are sweeping epidemics that affect millions of individuals worldwide.
Page | 14
Substance Abuse, although often regarded as a personality disorder, may also be seen as a worldwide epidemic
with evolutionary genetic, physiological and environmental influences controlling this behavior [8]. Since the
early times, herbs, leaves and plants have been used to heal and control diseases. The use of drugs in itself does not
constitute any danger, because drugs correctly administered have been a blessing. Aguocha [8] viewed that
“chronic use of substances can cause serious, sometimes irreversible damage to adolescent’s physical and
psychological development. The use of drugs could be beneficial or harmful depending on the mode of use. Drug
use has been noted as one of the most pressing health problems among students, who are an important and
vulnerable group in society [9]. In 2011, 22.5millionAmericans over 12 years of age (8.7% of the population)
reported using illicit drugs, compared to 8.3% in 2002, with the largest increase being for marijuana. Moreover,
while drug use remains highest among late teenagers and those in their twenties, an increasing trend has also been
noted among Americans in their fifties [10].Recent studies in African countries have shown that the phenomenon
of drug use is also common in this continent and is becoming one of the most disturbing health-related problems
among youth [7]/ Substances are used and abused widely among African youth. This situation poses serious
social and public health problems similar to those in most Western societies [9]. A study among Nigerian high
school students indicated that the lifetime prevalence of substance use was 87.3% whereas current use was 69.2%
with multiple substance use being 57.4% [8]. The lifetime prevalence rate of any substance use was found to be
69.8% among college students in Kenya [11].Globally, substance use of products such as alcohol, cigarettes, and
khat leaves (Catha edulis) has become a major public health concern with accompanying socio-economic problems.
Studies show that substance use, particularly in developing countries, has dramatically increased [12]. The Global
Burden of Disease Report projected that smoking and alcohol consumption were the 1 st and 4th leading risk factors
for early death and disability among males [13]. Substance use is harmful leading to decreased academic
performance, increased risk of contracting HIV and other sexually transmitted diseases (STDs), or psychiatric
disorders such as lethargy, hopelessness, insomnia [14]/ and depressive symptoms [15]. Half of the admissions in
the Ugandan National Mental Referral Hospital are young people with alcohol and substance use disorders
majority of whom are university students [16]. There is also a growing recognition of the high cost of treatment
and of the inability of existing treatment programs to keep up with increasing demand. The main objective of
institutions of higher learning in Uganda is to provide education and growth experiences for its students but
substance abuse has continued to be a problem in the university campuses that is slowing down their progress and
the sustainable development goals number 3 that envisages a healthy population and reduction of the prevalence
as well as the impact of alcohol abuse disorders in order to attain the highest possible level of physical, social and
mental health [16] Substance use is associated with a plethora of risky behaviors and negative health outcomes
including addiction, anxiety disorders, violent behaviors, paranoia, lung disease, hypoxia, heart failure, increased
risk of premature delivery, and various sexually transmitted diseases [10]. Understanding the key determinants of
substance use among University students is critical in creating targeted interventions and lowering the
socioeconomic burden associated with such behaviors. Against this background, this study was conducted to find
out the prevalence and determinants of substance use among students attending Kampala International
University-Western Campus.
METHODOLOGY
Study Design
The study was descriptive and analytic study using cross-sectional survey research design utilizing quantitative
methods of data collection. The cross-sectional survey research design was used because the method gathers data
from a relatively large number of different categories of respondents at a particular time in a quantitative manner.
©Kuteesa, 2024
Area of Study
The study was conducted at Kampala International University which is in Ishaka Town, a major town in Bushenyi
district, located in the north of Bushenyi district, southwest of Mbarara district and around 78km from Mbarara
town which is the biggest city in Western Uganda. Bushenyi district is also located around 361km southwest of
Kampala (capital city) by road. Ishaka town’s coordinates together with the municipality as all are believed to be
0o 32’ 40.00’’N, 30o 8’ 16.00’’E (Latitude: 0.544445, Longitude: 30.137778).
Page | 15
Study Population
The study population of this study was the students of Kampala International University-Western Campus
Inclusion criteria
The students of Kampala International University-Western Campus who were full-time students, willing to
participate in the study, who had consented, and who were around at the time the study was conducted.
Exclusion
The exclusion criteria for this study were the students of Kampala International University-Western Campus who
were time students or were not registered with the university and those who with speech or hearing impediments.
Sample size calculation
The sample size for this study was calculated using Slovin’s formula based on the target population of 6,217
students studying at Kampala International University Western Campus.
Slovin’s formula is represented by
N
n=
1  N 0.05
2
Where;
n= Sample size
N Target population size of 6217)
E= Margin of error (0.05)
using a confidence level of 95% (giving a margin of error of 0.05) and a total population of 6217 students:
6217/I Ɨ 6217 * 0.05 * 0.05) =176
The study as such involved 176 participants
Sampling procedures
The sampling technique that was employed was a non-probabilistic sampling technique of convenience sampling
to get the participants from whom the data was drawn; only those whom the researcher was able to convince were
included in the study.
Data collection techniques/methods and tools
Quantitative methods of data collection were used. Data was gathered from the study participants using closed-
ended questionnaires that required ticking an option from multiple choice.
Data collection tools
The researcher collected data from study participants using a structured self-administered questionnaire. It
consisted of three parts: (1) socio-demographic characteristics (2) prevalence of substance use, and (3) determinants
of substance use among students. The questionnaires were close-ended and required study participants to make
choices among several possible alternatives.
Validity of instruments
To ensure validity of data collection instruments, the data collection instruments were pretested by using a
content validity index, the researcher got respondents who were not part of the sample population, gave them
questionnaires and measured inter-respondent agreement. The agreement of more than 75% was a measure that
the items of the questionnaire could give the true representation of the results of the proposed study.
©Kuteesa, 2024
Reliability of data collection tool
The researcher ensured the reliability of the data collection tools by using data obtained from a pre-determined
questionnaire to determine the Cronbach’s coefficient alpha. An index of 0.84 was obtained which indicated that
the items of the questionnaire were reproducible and consistent.
Quality control techniques
The researcher ensured quality in the proposed study by, getting orientated about the research, the instruments,
Page | 16 and the field procedures required for effective and efficient field data collection. Field testing of the data collection
tools was done as part of the overall process of preparation for data collection. The principal investigator
monitored and supervised the overall study to ensure research procedures were adhered to. Besides, all completed
forms from the field were reviewed daily and on-the-spot feedback was provided with follow-up/callback
undertaken, where needed.
Data analysis plan
Data was entered using Microsoft Excel Version 13 and was analyzed using STATA 14.0. Before data entry, the
data was coded and cleaned to get any inconsistencies and missing values. Cross-checking was done where
necessary. The prevalence of substance use was analyzed in terms of frequency and percentage and information
was summarized in the form of tables, pie charts and narrations. Categorical variables were described in terms of
frequencies and percentages. A logistic regression model was used to determine independent factors associated
with substance use. Variables identified with a P value < 0.2 in univariate analysis were entered into the model.
Associations were represented in odds ratio (OR) and adjusted odds ratio (aOR) with 95% confidence intervals
(95% CI). A P value < 0.05 was considered as significant.
RESULTS
Socio-Demographic Characteristics of the Study Participants
As presented in table 1 below, a total of 176 participants were sampled from Kampala international University,
Ishaka-Bushenyi municipality, Bushenyi district. Majority of the study participants 125 (71.02%) were the female
participants whereas the minority of participants 51 (28.98%) were males. In terms of religion, the highest
proportion 54 (30.68%) of the study participants belonged to catholic religion followed by 51 (28.98%) who
belonged to the Anglican religion, 34 (19.32%) of the study participants were Muslims whereas 23 (13.07%) were
born again Christians, 09 (05.11%) of the study participants were Seventh Day Adventists meanwhile the least
number 05 (02.84%) of the study participants belonged to other religions. On assessing the age of study
participants, majority 107 (60.80%) of the study participants were in the age group of 25 – 30 Years followed by 51
(28.98%) of the study participants who were in the age group of 21 – 24 Years, 14 (07.955) of the study
participants belonged to the age group of 31 – 34 Years whereas 02 (01.14%) were in the age group of ≤ 41 Years
meanwhile minority 01 (0.57%) of the sampled participants were in the age group of 16 – 20 Years and the same
number of study participants were in the age group of 35 – 40 Years.
©Kuteesa, 2024
Table1: Shows demographic characteristics of the study participants

Category Options Frequency(N) Percentage (%)
Gender of the study participants Male 51 28.98
Page | 17 Female 125 71.02

Total 176 100.00
Religion of study participants Catholic 54 30.68
Anglican 51 28.98
Muslim 23 13.07
Born Again 34 19.32
SDA 05 02.84
Others 09 05.11
Total 176 100.00
Age of the study participants 16 – 20 Years 01 00.57
21 – 24 Years 51 28.98
25 – 30 Years 107 60.80
31 – 34 Years 14 07.95
35 – 40 Years 01 00.57
≥ 40 Years 02 01.14
Total 176 100.00
Figure 1
60
50
40
FREQUENCY
30
PERCENTAGE
20
10
0
Catholic Anglican Muslim Born Again SDA Others
Figure 1: Bar chart showing distribution of study participants by religion

The Prevalence of Substance use among Students Attending Kampala International University - Western
Campus.
To determine the prevalence of Substance use among students attending Kampala International University -
Western Campus, the study participants were asked to indicate how frequently they used some of the drugs which
©Kuteesa, 2024
were put in the questionnaire. Where 4 meant the substance was very frequently used by the study participant, 3
meant the substance was fairly frequently used by the study participant, 2 implied that the substance was used
frequently, and 1 showed that the substance was not in use by the study participant. Table 2 below shows the
prevalence of substance use among the study participants. It can be observed that the majority of the study
participants 100 (56.82%) were involved in substance abuse whereas 76 (43.18%) of the study participants were not
abusing any of the substances.
Page | 18
Table 2: Prevalence of Substance use among the study participants

Substance Use Frequency Percentage
Yes 100 56.82
No 76 43.18
Figure 2
No
43%
Yes
57%
Figure 2: Pie chart showing Prevalence of Substance use among the study participants
Table 3 below shows the level of use of the difference substances by the study participants. Majority of the study
participants 133 (75.57%) were using alcohol very frequently meanwhile the minority of study participants 08
(04.55%) did not use alcohol. Tobacco was used very frequently used by majority of the study participants
34(19.32%) whereas minority 24 (13.64%) of the study participants were not using tobacco. For Marijuana,
majority 70 (39.77%) of the study participants reported that marijuana was very frequently used, while 16(9.09%)
of the study participants reported that marijuana was not in use. Shisha, it was reported by 55 (31.25%) of the
study participants was used, whereas minority 35 (19.89%) of the study participants were not using shisha.
Majority (n=73, 41.48%) of the study respondents reported that kuber was not in use, while the minority (n=09,
05.11%) reported that kuber was very frequently used. On the other hand, Miraa was reported by 18(10.23%) of
the respondents as very frequently used, while 56(31.82%) of the respondents reported that it was not in use.
Majority of study participants 96 (54.55%) were very frequently using codeine as opposed to the minority 06
(03.41%) of participants who were not using codeine. The majority of study participants 121 (68.75%) of the study
participants indicated that opium was not in use, while the least number 01 (00.57%) indicated that opium was
frequent. Gasoline was reported not to be in use by the study participants, while 153(86.93%) of the respondents
reported that gasoline was not in use. Finally, the data collected revealed that the majority 112 (63.64%) of the
study participants indicated that cocaine was not in use, while 08(13.64%) of the respondents reported that cocaine
was very frequently used.
©Kuteesa, 2024
Table 3: Level of use of the different substances

Substance Options Frequency(N) Percentage (%)
Alcohol Very frequently used 08 04.55
Page | 19 Fairly frequently used 22 12.50
Used frequently 13 07.39
Not in use 133 75.57
Tobacco Very frequently used 34 19.32
Fairly frequently used 57 32.39
Not in use 24 13.64
Marijuana Very frequently used 35 19.89
Not in use 39 22.16
Shisha Very frequently used 47 26.70
Not in use 35 19.89
Kuber Very frequently used 09 05.11
Not in use 73 41.48
Miraa Very frequently used 18 10.23
Not in use 56 31.82
Codeine Very frequently used 06 03.41
Not in use 96 54.55
Opium Very frequently used 01 00.57
Gasoline Very frequently used 00 00.00
Cocaine Very frequently used 08 04.54
©Kuteesa, 2024
Page | 20 The Determinants of Substance Use among the Students at Kampala International University-Western Campus.
As presented in Table 4 below, the majority of the study participants 153 (86.93%) said that peer pressure is not
influential in determining substance abuse whereas the minority 02 (01.14%) of the study participants said peer
pressure is very influential in determining substance abuse. Family background was cited by the majority 77
(43.75%) of study participants as not influential to substance abuse meanwhile the minority 09 (05.11%) said family
background is very influential to substance abuse. 56 (31.82%) of the study participants mentioned that lack of
appropriate laws is fairly influential to substance abuse whereas 29 (16.48%) said lack of appropriate laws are very
influential. When asked about weight management, 90 (51.14%) of the study participants said it was very
influential while 16 (09.09%) said it was not influential. On the other hand, curiosity was mentioned by 62
(35.23%) of the study participants as not being influential whereas 14 (07.95%) said it was very influential.
Tendency to seek excitement was cited by 88 (50.00%) of the study participants as not influential to substance use
whereas 04 (02.27%) mentioned it as very influential. 123 (69.89%) of the study participants said night clubbing
was not influential to substance abuse meanwhile 04 (02.27%) of the study participants said night clubbing was
very influential to substance use. Poverty was mentioned by 67 (38.07%) of the study participants as being very
influential to substance use meanwhile 22 (12.50%) said it was not influential to substance use. When the study
participants were asked about school environment, majority 63 (35.80%) said it was fairly influential to substance
use meanwhile minority 22 (12.50%) said it was very influential to substance use. Majority of the study
participants 129 (73.30%) strongly disagreed that they knew about drugs from their friends while the minority 03
(01.70%) were undecided. Majority 117 (66.48%) of the study participants strongly disagreed that they had some
friends who were taking drugs whereas 02 (01.14%) of the study participants were undecided whether they had
some friends who were taking drugs. On the statement of using substances to belong to friends, the majority of the
study participants 92 (52.27%) strongly agreed whereas the minority 03(01.70%) were undecided. 123 (69.89%) of
the study participants strongly agreed that they had parents who also use substances contrary to the 07 (03.98%)
of the undecided study participants.117 (66.48%) of the study participants strongly agreed that they had cultures
which allow the taking of substances with a minority 05 (02.84%) being undecided. On the other hand, the
majority of the study participants 68 (38.64%) strongly agreed that they had the perception that using substances
makes people cool as opposed to the 17 (09.66%) of the undecided study participants. Lastly, the majority of the
study participants 85 (48.30%) strongly agreed that they used substances to cope with stress meanwhile 13
(07.39%) agreed with the statement and 13 (07.39%) were undecided.
Table 4: Frequency table for determinants of substance use

Category Options Frequency(N) Percentage (%)
Peer Pressure Very influential 02 1.14
Fairly influential 15 08.52
Influential 06 03.41
Not influential 153 86.93
Family Background (Parents Also Drink) Very influential 09 05.11
Lack Of Appropriate Laws Very influential 29 16.48
©Kuteesa, 2024
Weight Management Very influential 90 51.14
Curiosity Very influential 14 07.95
Page | 21
Tendency To Seek Excitement Very influential 04 02.27
Night Clubbing Very influential 04 02.27
Poverty Very influential 67 38.07
School Environment Very influential 22 12.50
Knowing about substances from friends Strongly agree 13 07.39
Agree 04 02.27
Undecided 03 01.70
Disagree 27 15.34
Strongly disagree 129 73.30
Having some friends who take substances Strongly agree 12 06.82
Agree 03 01.70
Undecided 02 01.14
Disagree 42 23.86
Using substances to belong to friends Strongly agree 92 52.27
Agree 24 13.64
Undecided 03 01.70
Disagree 21 11.93
Having parents who also take substances Strongly agree 123 69.89
Agree 16 09.09
©Kuteesa, 2024
Undecided 07 03.98
Disagree 15 08.52
Culture which allows taking of substances Strongly agree 117 66.48
Agree 24 13.64
Page | 22
Undecided 05 02.84
Disagree 16 09.09
Perception that using substances makes people Strongly agree 68 38.64
cool
Agree 29 16.48
Undecided 17 09.66
Disagree 31 17.61
Coping with school stress Strongly agree 85 48.30
Agree 13 07.39
Undecided 13 07.39
Disagree 21 11.93
Teachers buying drugs for students Strongly agree 55 31.25
Agree 39 22.16
Undecided 09 05.11
Disagree 31 17.61
Stressful finance clearing Strongly agree 18 10.23
Agree 37 21.02
Undecided 24 13.64
Disagree 44 25.00
Exam failure Strongly agree 13 07.39
Agree 19 10.80
Undecided 17 09.66
Disagree 57 32.39
Bivariate Logistic Regression of Determinants of substance use

Table 5 below shows bivariate logistic regression to establish demographic determinants of substance use among
students attending Kampala International University - Western Campus. Results of the analysis showed that 3
variables were statistically associated with substance use among the study participants. Lack of appropriate laws
was found to be significantly associated with substance use; study participants said lack of appropriate laws was
not influential to substance use were 2.61 times more likely to use substances than their counterparts who said
lack of appropriate laws was very influential to substance use (cOR2.61, 95%CI 1.03 – 6.62, P=0.04). Weight
management was found to be significantly associated with substance abuse; study participants who confessed that
weight management was not influential to drug abuse were 16.40 times more likely to use substances as compared
to study participants who mention that weight management was very influential to substance abuse (cOR16.40,
©Kuteesa, 2024
95%CI 2.08 – 129.42, P=0.01). Then finally curiosity was found to be a determinant of substance abuse; study
participants who mentioned that curiosity was not influential to substance abuse were 3.83 times more likely to
use substances than their counterparts who said that curiosity was very influential to substance abuse (cOR3.83,
95%CI 1.15 – 12.75, P=0.03)Knowing about substances from friends was found to be significantly associated with
substance use; study participants who strongly disagreed that they counterparts who strongly agreed with the
statement (cOR 3.56, 95%CI 1.04 – 12.16, P=0.04). Having some friends who take substances also had a statistical
Page | 23 association with substance use; those who strongly disagreed that they had some friends who were using
substances were 11.71 times more likely to abuse substances than those who strongly agreed (cOR 11.71, 95%CI
2.44 – 56.25, P=0.01). The variable of using substances to belong to friends was found to be statistically associated
with substance use; those who strongly disagreed with the statement were 13.68 times more likely to use
substances compared to those who strongly agreed with the statement (cOR 13.68, 95%CI 3.91 – 47.82, P<0.01).
A culture which allows the taking of substances had a significant association with substance use; study participants
who strongly disagreed that their culture allows the taking of substances were 5.32 times more likely to abuse
substances than their counterparts who strongly agreed with the statement (cOR 5.32, 95%CI 1.14 – 24.84,
P=0.03). Another variable found to be statistically associated with substance use was Perception that using
substances makes people cool; those who strongly disagreed with the statement were 12.55 times more likely to
use substances than those who strongly agreed with the statement (cOR 12.55, 95%CI 3.48 – 45.32, P<0.01).
Lastly, study participants who strongly disagreed that they used substances as a way of coping with stress were
11.79 times more likely to use substances than study participants who strongly agreed that they used substances
to cope with stress (cOR 11.79, 95%CI 3.48 – 45.32, P<0.01)Teachers buying drugs for students was found to be
statistically associated with substance use; study participants who strongly disagreed that teachers buying drugs
for students contribute to substance use were 4.09 times more likely to use substances than those who strongly
agreed with the same statement (cOR 4.09, 95%CI 1.65 – 10.13, P=0.002). Stressful finance clearing has significant
association with substance use; those who were undecided whether stressful finance clearing contributes to
substance use were 6 times more likely to use substances than those who strongly agreed (cOR 6.00, 95%CI 1.56 –
23.07, P=0.01) meanwhile study participants who strongly disagreed with the statement of stressful finance
clearing were 3.58 times more likely to use substance than those who strongly agreed (cOR 3.58, 95%CI 1.16 –
11.07, P=0.03). Finally, the variable of exam failure was found to be significantly associated with substance use;
study participants who strongly disagreed that exam failure contributed to substance use were 3.49 times more
likely to use substances than their counterparts who strongly agreed with the statement (cOR 3.49, 95%CI 1.02 –
11.90, P=0.04).
Table 5: Bivariate Logistic Regression of Determinants of Substance Use

Variable Category Substance Use Cor 95% Ci P Value
NO YES
(n=76) (n=100)
Gender Male 22 29 1 - -
Female 54 71 0.99 0.52 – 1.93 0.99
Religion Catholic 23 31 1 - -
Anglican 22 29 0.98 0.45 – 2.12 0.96
Muslim 06 17 2.10 0.18 – 6.16 0.18
Born Again 20 14 0.52 0.22 – 1.24 0.14
SDA 03 02 0.49 0.08 – 3.21 0.46
Others 02 07 2.60 0.49 – 13.68 0.26
Family Background (Parents Very influential 05 04 1 - -

Also Drink
Fairly influential 19 34 2.24 0.54 – 9.34 0.27
Influential 18 19 1.32 0.31 – 5.71 0.71
Not influential 34 43 1.58 0.39 – 6.34 0.52
Lack Of Appropriate Laws Very influential 16 13 1 - -
Influential 20 18 1.11 0.42 – 2.92 0.84
Not influential 17 36 2.61 1.03 – 6.62 0.04
©Kuteesa, 2024
Weight Management Very influential 47 43 1 - -
Fairly influential 07 16 2.50 0.94 –6.66 0.07
Influential 21 26 1.35 0.67 – 2.75 0.40
Not influential 01 15 16.40 2.08 – 129.42 0.01
Curiosity Very influential 08 06 1 - -

Page | 24
Influential 27 23 1.14 0.34 – 3.75 0.21
Not influential 16 46 3.83 1.15 – 12.75 0.03
Night Clubbing Very influential 02 02 1 - -
Influential 06 08 1.33 0.14 – 12.37 0.80
Not influential 51 72 1.41 0.19 – 10.35 0.73
Poverty Very influential 32 35 1 - -
Influential 23 38 1.51 0.75 – 3.06 0.25
Not influential 11 11 0.91 0.35 – 2.40 0.86
School Environment Very influential 10 12 1 - -
Influential 19 18 0.79 0.27 – 2.27 0.66
Not influential 20 34 1.42 0.52 – 3.87 0.50
Knowing about substances Strongly agree 09 04 1 - -

from friends
Agree 04 00 Omitted - -
Undecided 03 00 Omitted - -
Disagree 10 17 3.83 0.93 – 15.72 0.06
Strongly disagree 50 79 3.56 1.04 – 12.16 0.04
Having some friends who Strongly agree 10 02 1 - -

take substances
Agree 01 02 10.00 0.58 – 171.20 0.11
Undecided 00 02 Omitted
Disagree 30 12 2.00 0.38 – 10.51 0.41
Using substances to belong to Strongly agree 51 41 1 - -

friends
Agree 12 12 1.24 0.51 – 3.05 0.63
Undecided 01 02 2.49 0.22 – 28.41 0.46
Disagree 09 12 1.66 0.64 – 4.32 0.30
Strongly disagree 03 33 13.68 3.91 – 47.82 <0.01
Having parents who also take Strongly agree 60 63 1 - -

substances
Agree 04 12 2.86 0.87 – 9.35 0.08
Undecided 02 05 2.38 0.44 – 12.74 0.31
Disagree 05 10 1.90 0.62 – 5.90 0.26
Culture which allows taking Strongly agree 55 62 1 - -

of substances
Agree 12 12 0.89 0.37 – 2.14 0.79
Undecided 01 04 3.55 0.38 – 32.71 0.26
Disagree 06 10 1.48 0.50 – 4.33 0.48
The perception that using Strongly agree 39 29 1 - -

substances makes people cool
Agree 15 14 1.26 0.52 – 3.00 0.61
©Kuteesa, 2024
Undecided 06 11 2.47 0.82 – 7.44 0.11
Disagree 13 18 1.86 0.79 – 4.40 0.16
Coping with school stress Strongly agree 46 39 1 - -
Agree 07 06 1.01 0.31 – 3.26 0.99
Undecided 07 06 1.01 0.31 – 3.26 0.99

Page | 25
Disagree 12 09 0.88 0.34 – 2.32 0.80
Teachers buying drugs for Strongly agree 29 26 1 - -

students
Agree 20 19 1.06 0.47 – 2.41 0.89
Undecided 03 06 2.23 0.51 – 9.83 0.29
Disagree 15 16 1.19 0.49 – 2.87 0.70
Stressful finance clearing Strongly agree 12 06 1 - -
Agree 20 17 1.70 0.53 – 5.50 0.38
Undecided 06 18 6.00 1.56 – 23.07 0.01
Disagree 19 25 2.63 0.84 – 8.29 0.10
Exam failure Strongly agree 08 05 1 - -
Agree 11 08 1.16 0.28 – 4.92 0.84
Undecided 08 09 1.80 0.41 – 7.81 0.43
Disagree 27 30 1.78 0.52 – 6.10 0.36
cOR= Crude odds ratio. CI Confidence interval. The P-value is significant at a 0.05 level
Multivariate Logistic Regression to Identify Factors Independently Associated with Substance Use among the
University Students at Kampala International University-Western Campus.
Table 10 shows multivariate logistic regression to identify factors independently associated with substance use
among the University students at Kampala International University-Western Campus. Factors with a p-value less
than 0.20 with a bivariate logistic regression analysis were considered for multivariate analysis. Through a
stepwise logistic regression with the removal of the least significant variable in each step, Weight Management,
Poor role modelling by teachers, Stressful finance clearing and too much freedom at campus remained significantly
associated with substance use among study participants. Study participants who confessed that weight
management was not influential to substance use were 61.6 times more likely to abuse substances than those who
said weight management was very influential (AOR 61.6, 95%CI 2.71 – 1381, P=0.01). Students who disagreed
that Poor role modelling by teachers contributes to substance use were 5.31 times more likely to abuse substances
than their counterparts who strongly agreed to the same statement (AOR 5.31, 95%CI 1.25 – 22.59, P=0.02).
Students who were undecided as to whether stressful finance clearing contributes to substance use were 17.08
times more likely to abuse substances than the students who strongly agreed to the same statement (AOR 17.08,
95%CI 2.51 – 116.4, P=0.004). Lastly, study participants who disagreed that too much freedom at campus
contributes to substance use were 88% protected from substance abuse compared to the study participants who
strongly agreed that too much freedom at campus contributes to substance use (AOR 0.12, 95%CI 0.02 – 0.65,
P=0.01).
©Kuteesa, 2024
Table 6: Multivariate Logistic Regression to Identify Factors Independently Associated with Substance
Use among the University Students at Kampala International University-Western Campus.
Variable Category Substance Use Aor 95% Ci P Value
NO YES
(n=76) (n=100)
Page | 26
Lack Of Appropriate Very influential 16 13 1 - -
Laws
Influential 20 18 0.60 0.11 – 3.20 0.55
Not influential 17 36 1.49 0.29 – 7.58 0.63
Weight Management Very influential 47 43 1 - -
Influential 21 26 1.02 0.31 – 3.34 1.00
Not influential 01 15 61.16 2.71 – 1381 0.01
Curiosity Very influential 08 06 1 - -
Influential 27 23 1.57 0.21 – 11.42 0.66
Not influential 16 46 1.45 0.19 –11.12 0.72
Culture which allows Strongly agree 55 62 1 - -
the taking of
substances Agree 12 12 0.10 0.01 – 1.27 0.08
Undecided 01 04 0.03 0.01 – 1.97 0.10
Disagree 06 10 0.99 0.11 – 9.06 0.99
Perception that using Strongly agree 39 29 1 - -
substances makes
people cool Agree 15 14 0.98 0.22 – 4.38 0.98
Undecided 06 11 4.00 0.58 – 27.52 0.16
Disagree 13 18 1.13 0.20 – 6.47 0.89
Poor role modelling Strongly agree 14 11 1 - -
by teachers
Agree 14 16 3.27 0.73 – 14.76 0.12
Undecided 11 09 2.71 0.58 – 12.68 0.21
Disagree 17 23 5.31 1.25 – 22.59 0.02
Teachers buying Strongly agree 29 26 1 - -
drugs for students
Agree 20 19 0.59 0.18 – 2.03 0.41
Undecided 03 06 0.74 0.12 – 4.74 0.75
Disagree 15 16 0.98 0.27 – 3.57 0.98
Stressful finance Strongly agree 12 06 1 - -
clearing
Agree 20 17 3.69 0.73 – 18.67 0.11
Undecided 06 18 17.08 2.51 – 116.4 0.004
Disagree 19 25 3.47 0.74 – 16.38 0.12
©Kuteesa, 2024
Too much freedom at Strongly agree 06 09 1 - -
campus
Agree 07 05 0.23 0.03 – 1.73 0.15
Undecided 04 09 1.03 0.13 – 8.07 0.98
Disagree 42 19 0.12 0.02 – 0.65 0.01
Page | 27
Exam failure Strongly agree 08 05 1 - -
Agree 11 08 0.80 0.12 – 5.29 0.82
Undecided 08 09 1.93 0.29 – 12.71 0.49
Disagree 27 30 1.77 0.32 – 9.71 0.51
AOR= Adjusted odds ratio. CI Confidence interval. P Value significant at 0.05 level
DISCUSSION
The Prevalence of Substance use among Students Attending Kampala International University - Western Campus
Stafstrom & Agarth [17] found out that almost half of the students in Mbarara University in Uganda were
current alcohol users, and a quarter of them had engaged in heavy episodic drinking unlike in the present study
where majority of the students most frequently abused gasoline. Alcohol was the most used substance in the
previous study probably because it is cheaper than the other substances. A study done among students in selected
Universities in Kampala Uganda found out that, 55.2% were using substances which is in line with the finding of
the present study where 56.82% of the study participants were substance users. A possible reason for the
agreement of study findings could be because both studies were conducted in the same country [18]. A cross-
sectional survey done in Selected Secondary Schools in Uganda revealed that about 70.1% had ever used
substances. Only 39.1% abused substances and this figure is low when compared to the prevalence found in the
present study [16]. The reason for the discrepancy could be because the previous study was done among
secondary students. The results of this study also indicate that Alcohol is the most used substance followed by
Marijuana, Shisha and the least substance used is Gasoline. These findings are in agreement with earlier studies on
substance and drug abuse among students, such as the one done in Kampala and Wakiso schools which found that
Alcohol and cannabis(marijuana) were the most commonly abused substances and drugs among students [19].
Another recent study done to find out the prevalence and risk factors for substance and drug abuse among
university students in South Western, Nigeria noted that the above drugs were some of the most commonly
abused drugs among students [20]. The above findings for the commonly abused substances and drug abuse
among students at Kampala International University-Western Campus can be attributed to the fact that these
drugs, most especially alcohol, are readily available and can be conveniently purchased at a cheap price which
university students can afford. Alcohol isn’t illegal and can be obtained from shops, bars, and restaurants. Despite
the ban on selling Waragi in sachets by the government of Uganda, the students still buy this sachet alcohol
cheaply since it is now packed in small plastic bottles at less than the same price and quantity as the banned sachet
Waragi. A good section of the students whom the researcher interacted with also claimed they are more open to
using marijuana since they believe it is not as harmful as tobacco and alcohol. They also think it is “hip and trendy”
to smoke or take marijuana. Even with the ban on shisha, the drug is still sold in bars all over the country [19].
Students, especially females, indulge themselves in these drugs.
Determinants of Substance Use among the University Students at Kampala International University-Western
Campus.
The second specific objective of this study was to determine the determinants of substance use among the
university students at Kampala International University-Western Campus. After adjusting for confounders,
weight management, Poor role modelling by teachers, Stressful finance clearing and too much freedom at campus
were found to be independent determinants of substance use among the study participants. Study participants who
confessed that weight management was not influential to substance use were 61.6 times more likely to use
substances than those who said weight management was very influential (AOR 61.6, 95%CI 2.71 – 1381, P=0.01).
The finding of the study is in line with the finding of a descriptive cross-sectional study which employed a
©Kuteesa, 2024
quantitative method of data collection was used which involved 100 study participants from a population of
students in selected universities in Uganda. Results of the study revealed that weight management was found to be
significantly associated with substance use (X2=6.626. P-value=0.010) [18].When university students at Bishop
Stuart University and Mbarara University of Science and Technology were asked about the perceived factors that
influenced them to use substances, some of them cited that the desire to manage their weight forced them into
using substances to remain attractive [21, 22]. This finding is in line with the finding of the present study and the
Page | 28
possible reason for agreement of the study finding could be because both studies were conducted in the same
geographical region. In a research that was carried out in Nigeria by Abbot et al. [19], it was found that being a
desire to manage weight was associated with a high risk of substance abuse. This finding is consistent with what
was found in the present study. Similarly, a study among Egerton University Students in Njoro-Kenya found a
significant association between the prevalence of substance use and the need for weight management [23]. This
finding is in agreement with the findings of the present study. The result of this study is consistent with what was
found by Zarin et al. in their study conducted to find out the prevalence and socio-demographic determinants of
substance abuse among degree and college students of Meerut city. They found that substance use was statistically
associated with weight management [24].. According to Shek and Lin [25], significant changes in problem
behavior occur over brief periods in early adolescence, especially during the transition to middle school. The
literature addressing gender identity, peer relationships and rural communities indicate that students attending
rural, middle schools are particularly at risk for illegal drug use and peers are likely to play a pivotal role in the
behavior. Poor role modelling by teachers (AOR 5.31, 95%CI 1.25 – 22.59, P=0.02); Students who disagreed that
Poor role modelling by teachers contributes to substance use were 5.31 times more likely to abuse substances than
their counterparts who strongly agreed to the same statement. Drug use is spreading like a mushroom and
invading every level of each nation like home, educational institution and affecting individuals of all classes.
Everywhere the target group is our young population between the ages of 18 to 30. This is the period of life for
exploration and experimentation - the means by which ‘young people learn who they are and what they want to do
with their lives’, and trying out new things and making first-time choices [25]. It is the responsibility of the
teachers or the lecturers to show good example to the students by being good role models but when they exhibit
poor role modeling it can be dangerous to the students. Engagement in substance use can have negative
implications for young adults. Previous research has shown that substance use at young ages is associated with
decreased educational attainment and labor market productivity [26]. Binge drinking in particular has been linked
to driving under the influence of alcohol (DUI) and accidental deaths in college-age students. As illicit drugs are
illegal the use of these substances places young adults at risk of involvement in the criminal justice system. Thus,
substance use can have substantial negative consequences for young adults [19]. Such consequences could be
curbed if the teachers and lecturers exhibit good role modeling. Stressful finance clearing (AOR 17.08, 95%CI 2.51
– 116.4, P=0.004); Students who were undecided as to whether stressful finance clearing contributes to substance
use were17.08 times more likely to use substances than the students who strongly agreed to the same statement.
The result of this study is in line with the finding of a study conducted among students in Woreta Town,
Northwest Ethiopia which found that stressful finance clearing was significantly associated with substance use
[27]. When university students at Bishop Stuart University and Mbarara University of Science and Technology
were asked about the perceived factors that influenced them to use substances, they cited the stressful finance
clearance process they were subjected to by the university accounts department forced them into using substances
to vent their disappointment, at exam time, this stressful clearance they were subjected to made some of them miss
out on exams [24]. This finding is consistent with the finding of the present study and the possible reason for the
consistency could be because of the similarity of the study sites and similarity of the study designs used in the 2
studies. Too much freedom at campus (AOR 0.12, 95%CI 0.02 – 0.65, P=0.01); study participants who disagreed
that too much freedom at campus contributes to substance use were 88% protected from substance abuse compared
to the study participants who strongly agreed that too much freedom at campus contributes to substance use.
When students find too much freedom at campus, it makes them vulnerable to experiment substances. They try to
remove depression using drugs as a tool. Failed relationships and broken hearts are also major inducements of
substance abuse in young people and all these result from too much freedom at campus. Young people belonging
to the higher class of the society take alcohol and other drugs to maintain their status in the friend circles [28]. A
©Kuteesa, 2024
cross-sectional study carried out with students from urban and rural public schools in a countryside city in Goiás,
Brazil revealed that too much freedom at campus (adPR = 1.60) was associated with substance abuse among the
study participants [29].A validated questionnaire was used in a cross-sectional survey which was conducted
among 230 undergraduate and postgraduate medical students in a private medical college. Results showed that
freedom on campus was significantly associated with substance abuse among the study participants [1]. A study
done among university students in Turkey revealed that studying being given a lot of freedom at campus, was
Page | 29
significantly positively associated with substance abuse among the study participants [30]. The findings of the 2
previous studies above are all consistent with the findings of the present study.
CONCLUSION
This study has shown that the level of substance use is high among the study participants which is a clear
indication that the university administration has to come up with strategies to curb the vice. The study concluded
that the determinants of substance abuse were weight Management, poor role modelling by teachers, stressful
finance clearing and too much freedom on campus.
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CITE AS: Kuteesa Arnold James (2024). Prevalence and Determinants of

Substance Use among Students at Kampala International University
Western Campus, Ishaka Municipality Bushenyi District Uganda.
EURASIAN EXPERIMENT JOURNAL OF MEDICINE AND MEDICAL
SCIENCES 5(1):13-30
©Kuteesa, 2024

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Page | 13 Prevalence and Determinants of Substance Use among

Table1: Shows demographic characteristics of the study participants

Page | 17 Female 125 71.02

Figure 1: Bar chart showing distribution of study participants by religion

Table 2: Prevalence of Substance use among the study participants

Table 3: Level of use of the different substances

Table 4: Frequency table for determinants of substance use

Bivariate Logistic Regression of Determinants of substance use

Table 5: Bivariate Logistic Regression of Determinants of Substance Use

Female 54 71 0.99 0.52 – 1.93 0.99

Anglican 22 29 0.98 0.45 – 2.12 0.96

Muslim 06 17 2.10 0.18 – 6.16 0.18

Born Again 20 14 0.52 0.22 – 1.24 0.14

SDA 03 02 0.49 0.08 – 3.21 0.46

Others 02 07 2.60 0.49 – 13.68 0.26

Family Background (Parents Very influential 05 04 1 - -

Influential 18 19 1.32 0.31 – 5.71 0.71

Not influential 34 43 1.58 0.39 – 6.34 0.52

Lack Of Appropriate Laws Very influential 16 13 1 - -

Fairly influential 23 33 1.77 0.71 – 4.37 0.22

Influential 20 18 1.11 0.42 – 2.92 0.84

Not influential 17 36 2.61 1.03 – 6.62 0.04

Fairly influential 07 16 2.50 0.94 –6.66 0.07

Influential 21 26 1.35 0.67 – 2.75 0.40

Not influential 01 15 16.40 2.08 – 129.42 0.01

Curiosity Very influential 08 06 1 - -

Fairly influential 25 25 1.33 0.40 – 4.40 0.64

Not influential 16 46 3.83 1.15 – 12.75 0.03

Night Clubbing Very influential 02 02 1 - -

Fairly influential 17 18 1.06 0.13 – 8.38 0.96

Influential 06 08 1.33 0.14 – 12.37 0.80

Not influential 51 72 1.41 0.19 – 10.35 0.73

Poverty Very influential 32 35 1 - -

Fairly influential 10 16 1.46 0.58 – 3.69 0.42

Influential 23 38 1.51 0.75 – 3.06 0.25

Not influential 11 11 0.91 0.35 – 2.40 0.86

School Environment Very influential 10 12 1 - -

Fairly influential 27 36 1.11 0.41 – 2.95 0.83

Influential 19 18 0.79 0.27 – 2.27 0.66

Not influential 20 34 1.42 0.52 – 3.87 0.50

Knowing about substances Strongly agree 09 04 1 - -

Disagree 10 17 3.83 0.93 – 15.72 0.06

Strongly disagree 50 79 3.56 1.04 – 12.16 0.04

Having some friends who Strongly agree 10 02 1 - -

Disagree 30 12 2.00 0.38 – 10.51 0.41

Strongly disagree 35 82 11.71 2.44 – 56.25 0.01

Using substances to belong to Strongly agree 51 41 1 - -

Undecided 01 02 2.49 0.22 – 28.41 0.46

Disagree 09 12 1.66 0.64 – 4.32 0.30

Strongly disagree 03 33 13.68 3.91 – 47.82 <0.01

Having parents who also take Strongly agree 60 63 1 - -

Undecided 02 05 2.38 0.44 – 12.74 0.31

Disagree 05 10 1.90 0.62 – 5.90 0.26

Strongly disagree 05 10 1.90 0.62 – 5.90 0.26

Culture which allows taking Strongly agree 55 62 1 - -

Undecided 01 04 3.55 0.38 – 32.71 0.26

Disagree 06 10 1.48 0.50 – 4.33 0.48

Strongly disagree 02 12 5.32 1.14 – 24.84 0.03

The perception that using Strongly agree 39 29 1 - -

Disagree 13 18 1.86 0.79 – 4.40 0.16

Strongly disagree 03 28 12.55 3.48 – 45.32 <0.01

Coping with school stress Strongly agree 46 39 1 - -